Beyoglu Eye J. 2022; 7(1): 1-8 | DOI: 10.14744/bej.2021.17362

Comparison of Postoperative Corneal Astigmatism Induced by Two Different Corneal Incisions during Microincisional Cataract Surgery

Melisa Zisan Karslýoðlu¹, Cem Kesim¹, Ayþe Yýldýz Taþ², Murat Hasanreisoðlu², Orkun Müftüoðlu², Afsun Þahin^2
1Department of Ophthalmology, Koc University Hospital, Istanbul, Turkey
²Department of Ophthalmology, Koc University, Faculty of Medicine, Istanbul, Turkey

INTRODUCTION: Clear corneal incision (CCI) architecture in modern microincision cataract surgery (MICS) plays an undeniable role in postoperative refraction. The goal of this study was to evaluate the effect of hinge incision prior to two-step CCI on postoperative refractive astigmatism after cataract surgery and to demonstrate the schematic presentation of these postoperative astigmatic changes via double-angle polar plots.
METHODS: This study involved a consecutive case series of patients who had MICS. The first incision was performed as a two-step CCI, whereas the second was made as a hinge incision prior to 2-step CCI. The preoperative corneal and postoperative refractive astigmatism and surgically induced astigmatism (SIA) were calculated by vectorial analysis. Hotelling’s T2 test was performed to compare the centroid values of preoperative and postoperative corneal astigmatism.

RESULTS: A total of 63 eyes from 57 subjects were evaluated. Group I consisted of 27 eyes with the two-step CCI, and Group II included 36 eyes with the hinge incision prior to two-step CCI. No significant difference was found between the groups in terms of age, sex, axial length, keratometry readings, implanted intraocular lens power, and postoperative spherical equivalent. The centroids of corneal astigmatism postoperatively increased to 0.21 D at 87.6°±0.61 with no significance in Group I (p=0.525) and to 0.70 D at 90.6°±0.47 with significance in Group II (p=0.032). The difference in postoperative centroids between the two groups was also significantly different (p=0.043). Finally, the centroids of SIA were 0.12 D at 85.5°±0.50 and 0.22 D at 91.1°±0.49 for Group I and Group II, respectively, with no significance.

DISCUSSION AND CONCLUSION: A hinge incision did not have an unfavorable effect on postoperative refractive astigmatism; therefore, it may be preferred for controlled entrance to the anterior chamber.

Keywords: Centroid value, incision architecture, microincision cataract surgery, surgically induced astigmatism, vectorial analysis.

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